This Assisted Fascial Stretch provider, Abigail S. Moore, is a National Academy of Sports Medicine Certified Personal Trainer & Stretch & Flexibility Coach (NASM-CPT/SFC) and Certified Frederick Stretch Therapist (CFST). Manual assisted stretch services may be provided by certified personal trainers under state and local law.
You understand that stretching is generally known to help increase flexibility and mobility as well as ease tension and discomfort. Stretch services are NOT intended to diagnose, prevent, or treat any medical condition, and you should consult your doctor if you are experiencing continual and severe pain in any area of your body. You should consider consulting your physician before participating in any stretch service or regimen.
It is your responsibility to provide complete and accurate information on this Assisted Fascial Stretch Intake Form and to inform your provider of any pre-existing condition, limitations, or sensitivities. All stretch services should stay within your comfort level. If you DO experience discomfort or pain during your service, you agree to immediately alert your provider so that adjustments can be made. If your provider is unable to relieve your pain or discomfort after you request an adjustment, you agree to inform the provider that you would like to end the session immediately. You may also end the service at any time should you prefer/need to do so. If you have any questions or concerns about your service or stretch provider, you agree to bring them to your provider’s attention. Inappropriate or illegal conduct will not be tolerated in any manner. Your provider, Abigail S. Moore, reserves the right to refuse or discontinue a service if it is determined to be unsafe or cause you discomfort or if you engage in any inappropriate conduct as determined in your provider’s sole discretion.
By signing below you understand, acknowledge, and agree that you are voluntarily participating in the service provided (Assisted Fascial Stretch) and hereby voluntarily accept all risk and responsibility associated with the service provided. You hereby waive all claims, assume all liability, and release, hold harmless, indemnify, and agree to defend your provider, Abigail S. Moore, from liability for any injury claim, cause of action, suit, demand, and damages (including, without limitation, personal, bodily, or mental injury, property damage, economic loss, consequential damages, and punitive damages), arising from or related to (1) your failure to disclose any pre-existing conditions, limitations, or sensitivities; (2) your failure to inform your provider of any discomfort or pain during or at the end of your service; (3) your provider’s presence or use of equipment on your property as necessary to provide this service; and/or (4) any negligence on the part of your provider. You further expressly agree that this Assumption of Risk, Release, Waiver of Liability and Indemnification is intended to be as broad and inclusive as is permitted by law and that if any portion of it is held invalid, the balance shall be valid and continue in full legal force and effect.
You acknowledge and agree that your consent to this Assumption of Risk, Release, Waiver of Liability and Indemnification, is given in exchange for the rendering of Assisted Stretch services provided by Abigail S. Moore, and agree that this Assumption of Risk, Release, Waiver of Liability and Indemnification shall apply to each session/service.